Is Medicare Coming To Mexico?

This article is from the Guadalajara Reporter and was authored by Bob Kelly.

US officials deny Medicare expansion

By BOB KELLY
A report that Medicare will launch a pilot program early next year through a Guadalajara hospital has raised the hopes of retirees but could not be confirmed by staff members of key Congressional committees or the U.S. State Department.
The Senate Finance Committee, which oversees the health insurance program, is not aware of any expansion outside the United States, said Carol Guthrie, press secretary for the Democratic majority.
Medicare still does not cover anyone in Mexicoexcept under special circumstances, said Ashley Glacel, press secretary for the Senate’s Special Committee on Aging. People who fall ill in the United States along its borders can be covered if the nearest hospital is in Mexico or Canada.
Federal Benefits officers attached to the United States Consulate in Guadalajara told The Reporter that “there are no provisions made for Medicare payments for treatment outside of the United States, directly, or through any Healthcare Management Organization, no matter who does the billing. We are assured that there have been no changes to that policy and for Medicare to expand its services to beneficiaries receiving care in a foreign country would require an act of Congress.”
Ed Clancy, the U.S.consular agent in San Miguel de Allende, said the embassy in Mexico City was not aware of any pilot program.
An e-mail originating from the
Lake
Chapala area said, “Medicare is coming to Guadalajara in early 2008. It will begin as a pilot program at one Guadalajara hospital (which shall remain nameless for now) and will begin by first enrolling only California expats and snowbirds, perhaps because this is the state with the most expats living in Mexico.”
A phone call to the Ajijic number in the message was not answered and the sender did not respond to an e-mail query asking for the name of the hospital and other clarification.
“All eligible Medicare recipients will have to enroll in the program through the pilot hospital, bringing their U.S. Medicare card and one piece of ID,” the message said. “In the presence of a member of the hospital staff (probably at the Lake Chapala Society) they will be asked questions over the phone by someone at Medicare. Enrollment will begin late this year. The exact timetable has not yet been determined.”
The message said a public meeting has been tentatively set for November 17 at the Lake Chapala Society for persons eligible for military-related insurance programs and “a Medicare meeting will come later – December or January, probably.”
The sender of the e-mail said, “I will not be able to answer your individual questions. I am only acting as a facilitator between you and the hospital.” In a second message, the sender said, “the hospital has signed a contract with Medicare but has not yet received its Medicare number.”
David Warner, a University of Texas professor who has studied the feasibility of offering Medicare in Mexico, said he was not aware of any plan for a pilot program or of Congressional approval to offer coverage outside the United States.
“So far as I know, there has been no expansion of coverage to Mexico,” Warner said. “It is possible that someone with a Medigap policy or a Medicare Advantage policy could be covered for an emergency during their first 60 days on a trip out of the country but that is the only exception I am aware of.”
Warner, a professor at the university’s Lyndon B. Johnson School of Public Affairs in Austin, has directed two studies to determine if expanding coverage to Mexico could be justified. The obvious advantages are significant savings to Medicare because of much lower health care costs in Mexico and to retirees living in Mexico who buy supplemental coverage, enroll in the Mexican system or pay out of pocket.
In recent years, Warner said, the Mexican government has been working towards further standardizing health professionals’ qualifications and regulating medical facilities, while private health insurance carriers in the United States have created products targeted to transnational populations that cover care on both sides of the U.S.-Mexico border. “These trends indicate that the infrastructure is developing to support the portability of Medicare benefits to Mexico,” he said.
Warner said his group plans to help draft a Medicare research and demonstration project to evaluate the effect of coverage in Mexico. The federal Center for Medicare and Medicaid Services (CMS), which administers Medicare coverage, would need Congressional approval to conduct such a program, he added.